Sprain | Physio Fusion

August 28, 2021

By Physio Team Appointments & Fees, bones, Exercises, good posture, Home exercises, Injury, Lockdown, online consultations, pain, pain management, Physio, Pilates & Exercise Classes, posture, rehabilitation, rotator cuff, shoulder, shoulder pain, Sprain, Therapy #injury, #physio, #rehab, evidence based, exercise, motivation, online consultation, pain, physical activity, Physio, physiotherapy, rehabilitation, Rotator cuff, Rotator cuff anatomy, Rotator Cuff injury, Rotator cuff sprain, shoulder injury, shoulder pain, Therapy

What is your Rotator Cuff and What does it do?

You may have seen videos or posts online about people talking about a specific area of your shoulder known commonly as the “Rotator Cuff” and wondered what they were on about. Your shoulders do a lot of important things you might take for granted! They help you get something off a high shelf, comb your hair, or play a game of cricket.

It’s a complicated process that your body makes look easy. And your rotator cuff is a big part of that. It protects and stabilizes your shoulder joint and lets you move your arms over your head. It’s importance is widely used in sports like swimming, tennis and netball.

In New Zealand healthcare, shoulder injuries have one of the highest prevalence when it comes to ACC claims and overall cost. Within this, rotator cuff injuries are among the most common pathologies affecting New Zealanders. Other pathologies include acromioclavicular injuries, dislocations, osteoarthritis and frozen shoulder.

So, what exactly is the cuff and how does it influence the shoulder?

The rotator cuff (RC) is a combination of four muscles that run through and attach onto specific areas of the humeral head (top of the arm bone).
Supraspinatus, Infraspinatus, Teres minor and Subscapularis are the four muscles comprising the RC and each one plays an important role however they all contribute to shoulder stability:

Supraspinatus	Infraspinatus	Teres Minor	Subscapularis
A thin triangular muscle that helps perform abduction	A thicker, triangular muscle that performs external rotation.	The smallest muscle of the cuff, helps with rotation as well	The largest muscle of the cuff performs internal rotation (arm behind your back!)

Many people suffer from shoulder pain, so here are the most common injuries that can happen at the rotator cuff:

Rotator Cuff Tear:

A rotator cuff tear is often the result of high levels of load over a short amount of time or a high impact force stressing one or more of the tendons/muscles. Fortunately, majority of tears are partial. Tears are more common in people with jobs that involve heavy loading or lifting or in high impact sports like rugby. It also can happen suddenly if you fall on your arm or try to lift something heavy. Common and easily treatable with conservative management by a physiotherapist, a rotator cuff tear can come right.

Rotator Cuff Tendinopathy:

A rotator cuff tendinopathy is the most common shoulder pain complaint/injury resulting in inflammation and irritation of one or more of the cuff tendons. This pathology is more common in individuals who have an occupation where repetitive use of the shoulder, particularly in an overhead position such as carpenters or painters, or individuals that play highly repetitive, throwing sports like tennis, baseball or volleyball. Once again, this injury is treatable by a physiotherapist, conservative management can be very effective in treating these injuries with a thorough, well planned exercise program to help get patients back to doing what they love.

Majority of people experience pain around the shoulder joint, with some movements being highly provocative. Tenderness on touch at the affected site is also common – this helps your physiotherapist hone in on potentially which tendon is causing those problems!

Medical management vs Physio management

Medical management will be advised by your local GP if you decide to see them first. They might prescribe NSAIDs (anti-inflammatory medications such as ibuprofen) to help with the pain you’re experiencing and recommend you see a physiotherapist. Depending on your injury as well as your ability to function, surgery may be an option if conservative medical and physio treatments don’t help. Most people get by without the need of surgery but some tears can be too large to heal without the use of surgical intervention.

Physiotherapy management is designed around reducing pain and disability, restoring range of motion and helping people return to work or sports to perform how they were prior to the injury. In the early stages of these injuries, rest and ice and/or heat are recommended to allow the inflammation to settle – then your physiotherapist will begin to introduce a detailed exercise program, this may include:

Isometric (static hold) exercises
Resisted movements using bands
Range of motion exercises to restore lost movement
Functional loading – task specific or sport specific

If this is successful, the last step is to build back up the strength that was lost over time – this is done by concentrically (against gravity) loading the affected tendons/muscles in a way that they adapt and lay down more tissue, grow and becoming stronger in hopes that you get to return to what you enjoy!

August 28, 2021

By Physio Team Appointments & Fees, back pain, body parts, ergonomics, Exercises, good posture, Home exercises, Injury, lifting, Lockdown, muscles, online consultations, pain, pain management, physical health, Physio, posture, rehabilitation, Sprain #injury, #physio, #physiotherapy, #rehab, Back pain, back strengthening, Blog, Ergonomics, evidence based, exercise, Injury, lifting, lifting technique, online consultation, pain, physical activity, Physio, physiotherapy, Posture, rehabilitation, spine, Therapy, work injury

Lifting Mechanics

IS IT DANGEROUS TO LIFT WITH A BENT BACK?

One common belief about lifting is that rounding your back when lifting an object is considered dangerous while lifting with a straight back is considered safe…

However, there is a lot of misinformation circulating around lifting mechanics and what is deemed “good technique” versus “bad technique.”

Here are some key myths and misinformation that you may have heard:

A ROUNDED BACK WHILE LIFTING OVER STRESSES THE BACK MUSCLES AND LIGAMENTS

Research has shown that regardless of lifting position, whether you’re stooped, squatting or weightlifting, your back has to produce the same amount of force. Statistically speaking, it’s not significantly different.

FLEXING THE SPINE WHILE LIFTING INCREASES THE LOAD ON THE LUMBAR DISCS

Under heavy loads, discs are unlikely to fail unless >95% flexion is achieved (which is near impossible)
With low loads, the disc is unlikely to fail unless you do thousands of repetitions continuously
Your body is an amazing adapter, this includes discs! Your discs can adapt and become more and more able to handle loads when stressed appropriately

THESE COMPOUND TO CAUSE INJURIES AND PAIN TO THE BACK MUSCLES AND DISCS

Resistance training has demonstrated through countless studies the ability to increase bone mineral density (BMD) of the lumbar spine. BMD is actually positively associated with the strength of the spinal discs and ligaments at that level. With appropriate loading and training, disc, ligament, bone and muscles are going to adapt favourably

A NEUTRAL SPINE IS SAFER, STRONGER, MORE EFFICIENT AND BETTER TO LIFT WITH

There is no significant difference between activities that encourage more spinal flexion and one’s that do not in the long term
Lifting with lumbar flexion is not a risk factor for low back pain
Research has shown lifting with a bent back is more metabolically and neuromuscularly efficient
When the spine is in extension during bent over activities, the hip is actually flexed to a greater degree – decreasing the ability for the glutes and hamstrings to create as much internal torque. Flexing the spine reduces this effect and reduces the moment arm for the hip extensors

STOP BACK PAIN & INJURIES BY LIFTING WITH A NEUTRAL SPINE

Your lumbar spine flexes every time your hip flexes! It is impossible to isolate one versus the other. It is also impossible to not flex while doing common movements
Extreme flexion however (>/=100%), may pose an increased risk under heavy loads, but not at light loads

You may still be wondering why you have back pain (stay tuned for our next blog!). Your pain may not be directly related to your lifting strategy.

Could you have pain with forward bending? Absolutely.

Is bending at the lumbar spine an increased risk for pain or injury? In the vast majority of situations, no.

If I have pain with forward bending, is it bad to temporarily limit doing so? Not at all.

Should I fear bending at the spine with or without pain or injury? No. Being fearful of flexing/moving your spine is actually a stronger predictor of disability and back pain.

Work on moving through your spine, after all it’s what it is designed to do! Choose comfortable movements and gain confidence over time, then build up your strength gradually with resistance training – try and not to push too fast, we want nice, healthy adaptation! Give your body time to adapt, back pain is not quick fix sometimes but you are resilient and with healthy, normal movements and some patience, you will be okay.

August 28, 2021

By Physio Team acute pain, Appointments & Fees, body parts, chronic pain, Exercises, feet, heel pain, Home exercises, Injury, Lockdown, lockdown wellbeing, muscles, online consultations, orthotics, pain, pain management, physical health, Physio, rehabilitation, Sporting, Sprain, tendon, Therapy #injury, #leginjury, #physio, #physiotherapy, #runners, #runninginjuries, achilles, Achilles pain, achilles rehab, aerobic, Blog, Clinic, evidence based, exercise, exercises, foot pain, foot rehab, heel pain, heel rehab, Injury, motivation, online consultation, pain, physical activity, Physio, physiotherapy, rehabilitation, sporting injury, Therapy

Disorders of the Achilles Tendon

Basic Anatomy

The Achilles tendon is the largest tendon in the human-body. It is a band of tissue that connects your calf muscles to your heel bone (calcaneus). This tendon primarily facilitates general mobility such as walking, running, climbing stairs, jumping, and standing on your tip toes, by helping to raise the heel off the ground.

Common Achilles Pathology

Achilles tendinitis and tendinosis are two common disorders and are typically classified as overuse injuries.

Achilles tendonitis involves inflammation of the Achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. This inflammation is typically short-lived. Over time, if this is left resolved, the condition may progress to degeneration of the tendon- Achilles tendinosis, in which case, the tendon loses its organized structure and is likely to develop microscopic tears.

There are two types of Achilles tendonitis and it is based on which part of the tendon is inflamed:

Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
Non-insertional Achilles tendonitis involves fibres in the middle portion of the tendon and tends to affect younger people who are active.

In both non-insertional and insertional Achilles tendinitis, damaged tendon fibres may also calcify (harden) and often bone spurs (extra bone growth) develop with insertional Achilles tendinitis. Achilles tendonitis may also increase your risk of sustaining an Achilles tendon rupture (tear).

Causes

Typically referred to as “overuse” conditions, Achilles tendonitis and tendinosis are often caused by the sudden increase in repetitive activity involving the Achilles tendon. This can put too much stress on the tendon too quickly, that can then lead to micro-injury of the tendon fibres. Because of this ongoing stress on the Achilles, the body is not able to repair the injured tissue. The structure of this tendon is then modified, resulting in continued pain and other symptoms. The Achilles tendon also has poor blood supply that makes it more susceptible to injury and may make recovery from injury slow.

Common factors that may lead to the development of disorders of the Achilles tendon include:

Weak and/or tight calf muscles
Rapidly increasing the amount or intensity of exercise within a short span of time
Hill climbing or stair climbing exercises
Presence of bony spurs in the back of your heel
Changes in footwear – especially changing from wearing high-heeled shoes to flat shoes
Wearing poor fitting, inappropriate, or worn out shoes during sporting activities
Exercising without adequate warm-ups and stretching
A sudden sharp movement which causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.
Excessive mobility
Poor feet positioning and biomechanics (excessive pronation and flattening of the arches of the foot)

Symptoms

Common symptoms include:

Pain and stiffness along the Achilles tendon especially first thing in the morning
Pain along the tendon or back of the heel that worsens with activity
Severe pain the day after exercising
Visible thickening of the tendon
Tenderness to touch
Bone spur
Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden “pop” in the back of your calf or heel, you may have torn your Achilles tendon. Please seek urgent medical attention if you think you may have torn your tendon.

Diagnosis

If Achilles tendonitis or tendinosis is suspected, please deter from any activity or exercise which causes the pain. It is advisable to see your doctor or physiotherapist as soon as possible so that an accurate diagnosis may be made and appropriate treatment recommended.

You will be asked about the nature and duration of your symptoms and the medical professional assessing you will have a look at your foot and ankle. Ultrasound scanning may be used to evaluate the damage to the tendon and/or surrounding structures.

An MRI may be recommended if symptoms persist. X-rays may also be taken to rule out other disorders which may cause symptoms like Achilles tendonitis and tendinosis.

Treatment

Treatment will depend on the nature, severity, and length of the injury. Generally speaking, the longer the symptoms are present before treatment commences, the longer the timeframe until full recovery is attained. Full recovery may take between three and nine months.

Initial treatment options in the early stages may include:

Rest – to avoid further injury to the area
Ice – to reduce inflammation
Elevation – to reduce swelling
Non-steroidal anti-inflammatory drugs to reduce pain and inflammation.

How physiotherapy can help:

Physiotherapy typically focuses on two main areas: treatment and rehabilitation. Treatment may entail massage, shockwave therapy, acupuncture, gait re-education, and gentle stretching, whereas, rehabilitation predominantly entails strengthening of the Achilles and surrounding musculature.

Strengthening of the muscles surrounding the Achilles tendon facilitates healing in the tendon itself. Strengthening is attained through the utilization of specific exercises, that will be taught by your physiotherapist. It is common for the rehabilitation programme to take up to three months.

Exercises

August 5, 2021

By Physio Team Exercises, Injury, Physio, Sporting, Sprain, Therapy, Work Injury Knee exercises, Knee injury, Knee joint, Knee pain blog, Knee sprain, Knee strengthening, Physio for knee, physiotherapy

KNEE PAIN

Knee pain is one of the most common musculoskeletal complaints that affects peoples of all ages.
Knee pain can result from injuries of traumatic nature or due to complications from medical conditions.

Depending on the structures involved, pain can be localized to a specific area or be felt all
around the knee.

ANATOMY OF KNEE

The knee joint is a hinge joint. Other than bearing the weight of the body, it’s primary function is to bend, straighten and rotate to a small degree. To achieve this function, the knee joint relies on a number of structures.

Bones

Knee joint consists of four bones to provide structure and weight-bearing ability.

Lower end of thigh bone (femur)
Upper part of shin bone (tibia)
Knee cap (patella)
Fibula (not involved in weight-bearing, but provides attachments for ligaments and tendons)

Ligaments

Four important ligaments connect the two big bones, providing multi-directional stability.

Cruciate ligaments

Anterior cruciate ligament (ACL)

Posterior cruciate ligament (PCL)

Collateral ligaments

Medial collateral ligament (MCL)

Lateral collateral ligament (LCL)

Cartilage

Glossy cartilage lines the end of each bone to protect and allow smooth movements against each other with almost no friction.
Meniscus is another type of strong cartilage that lines the upper surface of the tibia bone to cushion and stabilize the knee.

Tendons

There are two important tendons located on the front of the knee joint.

Quadriceps tendon is a strong durable tissue that extends from the quadriceps muscle and connects it to the knee cap.
Patella tendon connects the knee cap to the tibia bone.

Bursa

Bursa are fluid filled sacs that are found in areas that require the most protection. They occur where ligaments, muscles, skins, tendons or bones rub together.

Muscles

Many muscles cross the knee joint, some of which cross from the hip or ankle joints. Due to this, some people may experience knee pain as a result of muscle imbalances such as weakness, poor flexibility and or dynamic control.

CAUSE OF PAIN

Some of the common causes of knee pain include:

Ligamentous sprain
Meniscus injuries (bulge or tears)
Fracture or dislocation
Tendinitis, Sprains
Bursitis
Calcification
Baker’s cyst
Arthritis (osteoarthritis)
Overuse syndromes (patella-femoral syndrome, chondromalacia)
Autoimmune conditions (Infection, Gout, Lupus, rheumatoid arthritis)

WHEN TO SEEK HELP

Consult your doctor or physiotherapist if your symptoms have not subsided after one-week of consistent self-management (RICE, pain medications or alternative pain-relieving modalities), or if your knee pain is stopping you from managing your hobbies or day to day activities.

Immediate medical attention:

Knee pain from with the following signs and symptoms may require immediate attention:

Severe pain
Pain that does not resolve with rest
Sudden swelling or bruising
Clicking or locking of the knee
Inability to bend or straighten the knee
Inability to weight bear

SIGNS AND SYMPTOMS

Pain
Swelling
Bruising
Stiffness
Clicking, locking
Redness

DIAGNOSIS:

Treatment of your knee pain will depend on its underlying cause. So, it is all about the diagnosis.

A focused subjective and physical examination of your knee will be performed by your physiotherapist.

Subjective

Your physiotherapist will ask a range of questions

Location of pain – front or behind the knee
Description of pain – dull ache or sharp
The behavior of pain – constant or intermittent
Aggravating and easing factors
General health
Goals of treatment

Physical assessment

Your physiotherapist will inspect your knee joint to diagnose the source and the potential underlying cause(s) of pain.

You may be referred to have radiological Imaging to make or confirm the diagnosis.

Radiology

TREATMENT

In most cases, individuals suffering from knee pain respond well to conservative modes of treatment (pain relief, physiotherapy, acupuncture, etc). Surgical intervention may be required where conservative management has failed to optimize function and reduce pain.

CONSERVATIVE MANAGEMENT

A self-management remedy to control inflammation (pain and swelling) in acute or chronic knee pain is using the ‘RICE’ principle (rest, ice, compress, elevate)

Rest – refrain from activities that impose repetitive strain or aggravation of knee pain
Ice – use an ice pack for 10-15 minutes, 2 to 3 times per day (with care)
Compress – use a compression bandage to reduce swelling (not to be worn when sleeping)
Elevate – using pillows elevate injured leg. This works best when the leg is higher than the level of heart, to use gravity to help facilitate the circulation of fluid.

Pain medications

Over the counter pain relievers such as non-steroidal anti-inflammatory medications (ibuprofen, celecoxib) play an important role in reducing inflammation and pain.

(Note: If you have problems with bleeding, stomach ulcers or other liver, kidney conditions, anti-inflammatory medications MUST NOT be consumed without consulting your doctor.

Visit your general practitioner for more information on what medications are right for you.

Physiotherapy

After establishing your diagnostic findings, your physiotherapist will devise a tailored recovery programme to help you manage your pain, improve strength and flexibility.

Your physiotherapist will work with you to advance your understanding of your symptoms and provide a range of exercises, stretches and self-managing strategies that will help you be in control of your recovery.

As required, your therapist may liaise with your doctor or other health professionals (acupuncturist, podiatrist, knee specialists) to facilitate your progress.

Acupuncture/Acupressure

Acupuncture and acupressure are two different options available for individuals suffering from pain and swelling. While both aim to help control inflammation and fasten healing and recovery, acupuncture involves inserting thin needles into the body, whereas acupressure relies on hand pressure and some forms of massage.

Steroid Injection

In some instances, knee injections are recommended by your physiotherapist or doctor to reduce inflammation and relieve pain.

SURGERY

Surgical intervention may be required where conservative management has failed to optimize function and reduce pain. In this case your physiotherapist will refer you to a surgeon for the opinion of care.

EXERCISES FOR KNEE PAIN

The thought of exercise when you have knee pain can be daunting. However, your trusted physiotherapist will work with you to provide specific ‘pain-free’ exercises to get you started on effective strengthening.

Alternatively, low-impact activities such as cycling or elliptical machines are great. Notice what feels right for you. Swimming, jogging in water, or water aerobics may be appropriate if skin integrity is maintained.

Note: muscle soreness after a hard workout is normal.

If you experience sharp, shooting, or sudden knee pain you must consult your physiotherapist or doctor.

June 9, 2021

By Physio Team Exercises, Injury, online consultations, Physio, Sporting, Sprain, Therapy, Uncategorized #injury, #leginjury, #physio, #physiotherapy, #rehab, #runners, #runninginjuries, #shinsplints

SHIN SPLINTS NO MORE

Shin splints, medically known as medial tibial stress syndrome, is a collective term used to describe multiple conditions that cause shin pain. Therefore, it is important to establish that there is not one singular cause.

October 15, 2020

By Physio Team Exercises, Injury, online consultations, Physio, Sporting, Sprain, Therapy, Work Injury Blog, exercise, exercises, online consultation, physiotherapy, Therapy, work injury

5 COMMON MISCONCEPTIONS ABOUT PHYSIOTHERAPISTS – PART 2

Myth 1: When you see a physiotherapist you just lie on the bed and get given an ice or heat pack.

At Physio Fusion we use an active approach to treatments. Physiotherapy will include manual hands-on therapy to facilitate tissue healing and tissue load tolerance alongside an exercise program individualized to your needs.

Myth 2: If I have elbow pain then the injury must be in my elbow.

The area of pain is not always the area that is the issue! It may be a result of a previous injury that was never fully rehabilitated. This is where we can help you out. Our assessment will consist of gathering information on your presenting complaint, any previous injuries or traumas (physical and emotional) and a medical history followed by an objective evaluation of your body. This allows us to get to the root cause of the pain and manage your symptoms most effectively.

Myth 3: I can’t do any of my normal activities while I attend physiotherapy.

Not true! Our Physiotherapists want to keep you as functional as possible whilst allowing your injury to heal. During the initial assessment your physiotherapist will determine what activities you can do and advise you on those that must be avoided. You will then be given clear and timely objectives to ensure you reach your goals to get you back doing what you love!

Myth 4: A scan will show me exactly what is wrong.

Sometimes it will, but sometimes it won’t. It’s no secret that our bodies change as we age, so even people without pain are likely to have an imperfect scan. Medical imaging can sometimes play an important role in the assessment and management of your musculoskeletal issue. When necessary, your physiotherapist will know what type of imaging to refer you for.

Myth 5: Is cracking my back/neck/knuckles bad for me?

There is no strong evidence to suggest that ‘cracking’ your joints causes degeneration, laxity or instability. The ‘cracking’ occurs when we move a joint to its end range. The audible sound happens because of ‘cavitation’ in the joint; this involves gas bubbles popping within the fluid surrounding the joint as pressures change.

But is it good to crack?

Self manipulation can be a helpful way to reduce the feeling of stiffness or tightness. If you are finding that you need to ‘crack your joints’ often it is good to know that there are many other more beneficial ways to provide greater long term relief.

Top tips:

Ask your physiotherapist to provide you with some specific exercises to help you overcome the feeling of stiffness or tightness.
Move regularly and avoid movements or positions that exacerbate your symptoms until you have been seen by your physiotherapist.

May 8, 2020

By Physio Team Exercises, Injury, Physio, Sporting, Sprain, Therapy, Work Injury physiotherapy, Rotator cuff, Rotator Cuff injury, Rotator cuff sprain, Shoulder

Rotator Cuff Injury

Rotator cuff injuries are the most common source of shoulder problems. They can range from minor sprains causing impingement type symptoms, to massive tears resulting in severe loss of function and pain. They commonly occur as a result of acute injuries (sports, falls), chronic overuse (repetitive loading) or due to gradual aging.

Anatomy of shoulder

The shoulder joint (glenohumeral joint) is the most mobile joint in the human body. It comprises of the humeral head (top portion of upper arm bone) which fits in the glenoid cavity of the scapula (shoulder blade) to create a ball and socket configuration. This anatomical configuration results in limited bony contact between the humeral head and the glenoid fossa, which reduces the stability of the joint.

Several passive and active structures stabilize and maintain proper biomechanics of the shoulder joint.

Passive stabilizers include the ligaments, joint capsule, cartilage and the bony concavity of glenoid fossa. Thick cartilage known as labrum lines the glenoid fossa to further deepen the groove by about 50% which is advantageous in stabilizing the shoulder joint during the articulation.
Dynamic stabilizers of the glenohumeral joint is gained from the coordination of rotator cuff muscles that compress the passive structures providing stability and mobility as whole.

The four rotator cuff muscles include:

supraspinatus
infraspinatus
subscapularis
teres minor

Injury to any or all these four muscles, including the tendons that attach the muscles to bone can result movement dysfunction and severe pain.

Other important joints of the shoulder complex include:

sternoclavicular joint
arcomioclavicular joint
scapulothoracic joints

Types of rotator cuff pathology

Acute rotator cuff tear

Acute tears result from sudden forceful lifting of the arm against resistance or in an attempt to cushion a fall (for example, heavy lifting or a fall on the shoulder).

Chronic rotator cuff injury

Chronic rotator cuff tears are the result of gradual wear and tear that occurs slowly overtime with pain persisting more than three months.

There are several factors that contribute to this which include: repetitive strains, bone spurs, poor healing rate due to age.

Tendinitis and Tendinosis

More often than not the term tendinitis and tendinosis are interchangeably used to describe a similar tendon pathology. However, the factor that differentiates the two is the time of injury (acute or chronic).

Tendinitis results from acute injury to the tendon which sets off an inflammatory process characterized by pain, swelling, and redness. On the other hand, tendinosis is a chronic pathology that does not involve an inflammatory process. It is characterized by degeneration of collagen fibers in response to persistent micro-trauma, vascular compromise and aging.

Signs and symptoms

Symptoms of a rotator cuff injury are due to the inflammation that accompanies the strain. Swelling that forms within the small space of the joint prevents the normal mechanics of the shoulder, resulting in the clinical picture of pain and decreased range of motion.

Acute rotator cuff tears
Tearing sensation
Immediate severe localised pain
Reduced strength
Symptomatic clicking
Reduced and worsening pain with movements
Affects daily activities (personal care, lifting, reaching etc)
Chronic rotator cuff tears
Generalized deep dull ache, sharp onset of pain with movements
Global shoulder weakness
Reduced movements and daily activities (especially moving to the side, reaching behind back)

When to seek medical treatment

See your doctor or a physiotherapist if you experience any of the following symptoms in the shoulder:

Pain, especially pain that does not improve with rest
Swelling, redness or tenderness around the joint
Shoulder weakness
Reduced shoulder movement

Seek immediate medical attention if you experience the following symptoms:

Sudden, severe pain
Visible joint deformity
Inability to move or use your shoulder joint
Sudden swelling, discoloration

Diagnosis

To diagnoses an injured rotator cuff, your physiotherapist will begin with a thorough subjective and physical examination of your shoulder.

Subjective assessment

Your physiotherapist will begin with a thorough subjective assessment inquiring about your signs and symptoms of an acute injury as well as any symptoms that may suggest a more long-term problem.